What is Needed to Unravel a Gordian Knot is a Bold Stroke—Access and Coordination

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Today, Andy Wallace joins us with some concise advice on how to make our health care system work far better.He comes with a special perspective; a highly regarded physician specialist, a former medical center executive (former CEO of the Duke University Hospital), a former Dean of the medical school responsible for the Dartmouth Atlas and Vice President for Health Affairs at the Dartmouth Medical
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Medicare Advantage HMO Stocks Down Big This Week

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Matthew Holt, publisher of the Health Care Blog, and I have been in a state of incredulity over Wall Street’s head in the sand view of the Medicare Advantage business for more than a year. See his post today, "I Don't Really Understand Wall Street, Part 98."Why was it that in the wake of a Democratic take-over of Congress in 2006 and Obama’s victory last November that HMO stocks heavily invested
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Mr. President, Aren’t You Just Kicking the Can Down the Road?

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Pieces of the health care portion of the Obama budget are leaking out.Based upon published reports, the Obama “down payment on health care reform” will include:$634 billion to help pay for health care reform over the next ten years. $318 billion of that—about half—will come from tax increases that include reducing the mortgage and charity deduction for high income Americans.Charging wealthier
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"Obama Budget Would Creat $634 Billion Health Care Fund"

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Here is what Ceci Connolly is reporting at the Washington Post:President intends to release a budget tomorrow that creates a 10-year, $634 billion "reserve fund" to partially pay for a vast expansion of the U.S. health system, an overhaul that many experts project will cost as much as $1 trillion over the next decade.Obama would pay for the expansion by trimming tax breaks for the wealthy and
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For the Obama Administration Health Care Reform Will Require Really Tough Cost Containment—Coming and Going

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The President has made a powerful argument—America cannot get its economic house under control without comprehensive health care reform. The cost of existing entitlements—public and private—and any new ones are just too big a ball and chain on our short and long-term economic health.The President has also argued that there could be no better time to fix this mess than now—when it is so critical
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Raising the Price Before You Put It On Sale—The Obama Budget and His Health Plan

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The Obama budget team has made it clear they are going into the next federal budget process playing it straight on many fronts that the prior administration had fudged on.The cost of the wars, the cost of adjusting the alternative minimum tax each year to keep the middle class from falling into it, the cost of disaster relief, and the cost of avoiding the otherwise automatic cuts to Medicare
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SavingPrimaryCare.org Doing Good Work

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A comment to a recent post caught my attention.There is a new group of primary care practitioners doing some good work that deserves some attention.From their website:SavingPrimaryCare.org is an off-shoot of the Ideal Medical Practices Project that has been running since 2006. This grant funded project supports solo and small practices across the US as they struggled to provide
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“Leading Figures in the Nation’s Long-Running Health Care Debate…Appear To Be Inching Toward a Consensus”

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Robert Pear, in the New York Times, is reporting that, “leading figures in the nation’s long-running health care debate…appear to be inching toward a consensus that could reshape the debate.”He goes on to write, “While not all industry groups are in complete agreement, there is enough of a consensus, according to people who have attended the meetings, that they have begun to tackle the next steps
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The Big Stakeholders and Health Care Reform--No More Happy Talk?

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For a number of months I have been beating the drum that there is nowhere near the consensus for health care reform we need to get the big one done and that the key stakeholders are no more ready to give up valuable real estate to make it happen than they have been in years past.I got a call from Maggie Mahar earlier today to discuss an article in yesterday's Chicago Tribune, written by Julie
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Drug Industry Wins Comparative Research Fight in Stimulus Bill

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If you are looking for something to do over the weekend I suggest reading the one thousand page final stimulus bill.You can access it here.This past Wednesday, I posted the following regarding the differing health care comparative effectiveness research provisions in the House and Senate versions of the stimulus bill:Comparative research--which drugs or medical devices work the best--makes a lot
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Health Care Reform--The Stimulus PreGame

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"Drug Makers Fight Stimulus Provision""Lobbying War Ensues Over Digital Data"The first was a recent Wall Street Journal headline and the second headline comes from the Washington Post. Both refer to what were supposed to be two already agreed on health care reform ideas--comparative research about which treatments work best and the creation of a nationwide system of medical records. The lesson
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The "Cleanest and Strongest Lever" to Make Health Care Reform Work

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I like the Congressional Budget Office (CBO). In a town where self-serving BS generally pollutes the health care reform discussion these guys regularly play it down the middle. Are they always right? I suppose not. But they play the game on the up and up and that makes them noteworthy.Their latest contribution came from Director Doug Elmendorf. In Congressional testimony he said that, "The
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The AMA Wins A Round Against Patient Information

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The AMA Wins A Round Against Patient InformationBy BRIAN KLEPPEROn January 30th, a 3-judge DC appeals court overturned a lower court decision that would have forced public release of Medicare physician data. Writing for the majority in a split 2-1 judgment, Circuit Judge Karen LeCraft Henderson declared that, “The requested data does not serve any (freedom-of-information-related) public interest
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Ron Wyden for HHS Secretary

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Let me be the first to suggest that the President name Senator Ron Wyden (D-OR) to be the next Secretary of HHS.The withdrawal by Tom Daschle has underscored just how important it will be for the President to name someone who can bring a number of key strengths to the job. The right candidate will have:A high degree of respect from members of Congress--both Democrats and Republicans.An
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Daschel Withdrawal Sets Back Health Care Reform

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In many ways picking Tom Daschle to be HHS Secretary was the perfect choice. The former Senate majority leader knew Congress like the back of his hand, he wrote a book outlining not only what would be the Obama health plan but laid out the process to get there. He is an effective communicator on behalf of the administration on an issue that can easily become buried in controversial policy minutia
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The Daschle Appointment and "Limousine Liberals"

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Republicans are fond of referring to liberals who lead a comfortable life while claiming they understand the plight of the poor as "limousine liberals."I have a friend who says that when you first come to Washington you see it as this ugly political swamp but after you are here awhile it begins to seem like this wonderful hot tub. He says that's when it's time to get out of town and go back
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